Advice on respiratory viruses including COVID-19 for staff in health, social care and special schools

This guidance sets out the advice for health, social care and special school staff for managing respiratory viruses, including COVID-19. It is informed by public health and clinical advice which takes account of the current public health conditions. 

We will keep this guidance under review. 

Who this guidance applies to

This guidance replaces all previous versions and applies to health and social care staff working in close contact with patients and service users and staff working in special schools. 

Any staff member working in close contact with patients and services users who has symptoms of a respiratory infection including COVID-19 is advised to stay at home and notify their employer as soon as possible. Further advice on managing symptoms can be found in the Guidance for people with symptoms of a respiratory infection, including COVID-19.

When they no longer feel unwell, do not have a high temperature (if they had one) and are ready to return to work, they may wish to discuss with their employer ways to minimise any risk as some may still be infectious. This may include undertaking a risk assessment if the staff member works with patients whose immune system means that they are at higher risk of serious illness despite vaccination.

The testing of symptomatic staff is not routinely recommended. Access to free testing is now focused on supporting clinical management of patients and identification of vulnerable individuals who would benefit from specific anti-viral treatment for COVID-19 or influenza. Testing can  also support surveillance, infection control activities and the management of incidents or outbreaks in closed settings.

In the circumstances mentioned above where testing may be appropriate, staff who test positive should stay at home until they no longer have a high temperature and feel well enough to return to work. They should discuss with their employer ways to minimise risk on their return in line with normal return to work processes.

People who live in the same household as someone with a respiratory infection, including COVID-19, are at higher risk of becoming infected. This is because they are most likely to have prolonged close contact. People who stayed overnight in the household of someone with a respiratory infection, including COVID-19 while they were infectious are also at higher risk.

Staff who live with or are an overnight contact of someone who has symptoms of a respiratory infection or has had a positive COVID-19 test result should discuss ways to minimise risk of onwards transmission with their line manager.

This may include considering:

• Redeployment to lower risk areas for patient-facing healthcare staff, especially if the member of staff works with vulnerable patients including those who are immunosuppressed meaning  that they are at higher risk of serious illness despite vaccination (gov.uk)
• Limiting close contact with other people especially in crowded, enclosed or poorly ventilated spaces.

While they are attending work, staff must continue to comply rigorously with all relevant infection, prevention and control procedures. 

If staff develop any symptoms they should follow the advice for staff with symptoms of a respiratory infection, including COVID-19.

If staff  are a contact of someone with a respiratory infection but do not live with them or did not stay in their household overnight, they are at lower risk of becoming infected. They do not need to follow all of the advice set out above. However, they should pay close attention to the main symptoms of respiratory infections. If staff develop any symptoms, they are advised to stay at home and follow the advice set out above. Further information can be found in the Guidance for people with symptoms of a respiratory infection, including COVID-19.

Adherence to the current guidance on Infection prevention and control measures for acute respiratory infections (ARI) including COVID-19 for health and care settings - Wales is essential. This includes monitoring and reporting of outbreaks, good hygiene practices and the appropriate use of PPE.   

All health and care staff should be familiar with the principles of standard infection control precautions (SICPs) and transmission based precautions (TBPs) for preventing the spread of infection in health and care settings and should implement IPC measures in line with the National Infection Prevention and Control Manual for Wales NIPCM - Public Health Wales (nhs.wales).

It remains the responsibility of the health board or employer to ensure that staff and visitors comply with IPC guidance for health and care settings.